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  • Reflexivity in midwifery research: The insider/outsider debate

    Author(s)
    Burns, Elaine
    Fenwick, Jennifer
    Schmied, Virginia
    Sheehan, Athena
    Griffith University Author(s)
    Fenwick, Jennifer H.
    Year published
    2012
    Metadata
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    Abstract
    Objective to explore the challenges of conducting an observational study of postnatal interactions, between midwives and women, when the researcher was a midwife observing in familiar midwifery settings. Background participant observation conducted by researchers who are themselves midwives raises questions regarding the influence of 'identity' and 'insider' knowledge on the conduct of such projects. The insider/outsider status of researchers has been explored in other disciplines, yet this is an area which is underdeveloped in the midwifery literature where few attempts have been made to subject this issue to sustained ...
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    Objective to explore the challenges of conducting an observational study of postnatal interactions, between midwives and women, when the researcher was a midwife observing in familiar midwifery settings. Background participant observation conducted by researchers who are themselves midwives raises questions regarding the influence of 'identity' and 'insider' knowledge on the conduct of such projects. The insider/outsider status of researchers has been explored in other disciplines, yet this is an area which is underdeveloped in the midwifery literature where few attempts have been made to subject this issue to sustained analysis. Design a qualitative study (investigating the provision of breast-feeding support in the first week after birth) provided the opportunity for reflexive exploration of the tensions faced by midwife researchers. Setting two maternity units in New South Wales, Australia. Participants participants included 40 midwives and 78 breast-feeding women. Findings possessing 'insider' midwifery knowledge was advantageous in the 'getting in' and 'fitting in' phases of this research study however unanticipated role ambiguity, and moral and ethical challenges, arose as a result of this 'insider' knowledge and status. Prolonged periods of observation challenged the midwife researcher's preconceived ideas and early decisions about the advantages and disadvantages of being an 'insider' or an 'outsider' in the research setting. Key conclusions reflexive analysis of insider/outsider experiences revealed the middle ground which participant observers tend to navigate. Whilst professional insider knowledge and status offered many advantages, especially at the first study setting, some of the inherent embodied, and socially constructed features of the 'midwife' observer role, were unanticipated. Cultural competence, in these observational study settings, translated into role ambiguity, and at times, culturally entrenched role expectations. Implications for practice midwifery observation of clinical practice, for research, or practice development purposes, requires a degree of juggling of insider knowledge to facilitate observation and analysis. Prior to conducting observations midwives should consider how best to occupy the middle ground between insider and outsider. Within the middle ground the midwife can draw on those aspects of 'self' required to negotiate respectful relationships with colleagues, whilst also ensuring the maintenance of an analytical degree of distancing.
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    Journal Title
    Midwifery
    Volume
    28
    Issue
    1
    DOI
    https://doi.org/10.1016/j.midw.2010.10.018
    Subject
    Midwifery
    Nursing
    Paediatrics and Reproductive Medicine
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/49426
    Collection
    • Journal articles

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